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COVID-19政策应对:墨西哥卫生系统关键利益相关者的观点及其对恢复力的影响

COVID-19 Policy Response: Perspectives of Key Stakeholders in Mexico's Health System and Implications for Resilience.

作者信息

Díaz-Castro Lina, Díaz de León-Castañeda Christian, Pérez-Hernández Galileo, Suárez-Herrera José Carlos

机构信息

Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.

Investigadoras e Investigadores por México, Consejo Nacional de Humanidades, Ciencias y Tecnologías, Mexico; Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, Mexico.

出版信息

Arch Med Res. 2025 Feb;56(2):103097. doi: 10.1016/j.arcmed.2024.103097. Epub 2024 Oct 15.

Abstract

PURPOSE

This study aims to analyze the perspectives of key stakeholders within Mexico's health system regarding the policy response to COVID-19 in 2020 to inform future policy formulation.

METHODS

This qualitative study is based on a secondary data analysis (SDA) derived from a broader primary research on governance in Mexico during the COVID-19 pandemic. The analysis adopted a grounded theory approach to examine 15 semi-structured interviews with prominent figures in the health system between June and November 2020. The interviews were audio-recorded and analyzed through the lens of the Health Policy Triangle which includes context, key actors, and the Mexican health policy process. Moreover, the analysis was enriched by incorporating the framework outlined in the World Health Organization's COVID-19 Strategic Preparedness and Response Plan (SPRP).

RESULTS

The findings indicate that key stakeholders perceived a centralized approach to policymaking with a strong emphasis on cross-sector communication, expert panels, equity-focused measures, accessibility to healthcare services (promoting portability), and improvements in the health information system.

CONCLUSION

Key stakeholders recognized the response to COVID-19 was complex, involving multiple dimensions and levels of action. The importance of preparedness and response in building health system resilience is emphasized. Recommendations include explicitly integrating resilience into national and local policy agendas, addressing systemic structural deficiencies, promoting equity in the pandemic response, improving risk governance, strengthening coordination mechanisms, ensuring supply chain resilience, improving personnel training, and enhancing local diagnostic capacity to better prepare for future public health emergencies.

摘要

目的

本研究旨在分析墨西哥卫生系统内关键利益相关者对2020年应对新冠疫情政策的看法,以为未来政策制定提供参考。

方法

本定性研究基于二次数据分析(SDA),该分析源自对新冠疫情期间墨西哥治理情况进行的一项更广泛的初步研究。分析采用扎根理论方法,对2020年6月至11月期间与卫生系统知名人士进行的15次半结构化访谈进行了研究。访谈进行了录音,并通过卫生政策三角(包括背景、关键行为体和墨西哥卫生政策过程)的视角进行了分析。此外,通过纳入世界卫生组织《新冠疫情战略防范和应对计划》(SPRP)中概述的框架,使分析更加丰富。

结果

研究结果表明,关键利益相关者认为决策采用集中化方式,高度重视跨部门沟通、专家小组、注重公平的措施、医疗服务可及性(促进可携带性)以及卫生信息系统的改进。

结论

关键利益相关者认识到对新冠疫情的应对很复杂,涉及多个层面和行动水平。强调了防范和应对在建设卫生系统复原力方面的重要性。建议包括将复原力明确纳入国家和地方政策议程,解决系统性结构缺陷,促进疫情应对中的公平性,改善风险治理,加强协调机制,确保供应链复原力,改进人员培训,以及提高当地诊断能力,以便更好地为未来的突发公共卫生事件做好准备。

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